Hi All,
Just wondering if anyone was experiencing severe pain that appears to be dental that came about the same time as hypothyroidism. Dentists and consultant s are at a loss as to what the issue could be and have ruled out my teeth as a cause. It's a constant throbbing pain on lower left side of mouth. Any thoughts would be most appreciated as it is going on now about 6 years. Thank you
When hypothyroid it’s very common to clench teeth (TMJ) or grind teeth - Bruxism
Google both
Wearing a mouth guard at night can be astonishingly helpful
Hi,
Thank you for your reply. I do have TMJ and also wear a night guard, but they said that the level of pain I have is not due to grinding. Thank you for your help.
I swear dentists think we make stuff up.
About a year ago—actually, more like 18m ago—I had an upper molar repaired (a piece had broken off). Within a week I was in constant pain and nothing relieved for longer than about an hour at a time.
The dentist prodded and poked, couldn’t find anything. Doctors at my surgery prescribed an array of painkillers, even Pregabalin. Sent me for an MRI. Nothing to see. Eventually, the third GP I saw prescribed low dose Naproxen twice a day. I don’t think he expected for a second it would fix anything (and neither did I!) but it did! Within a few days, the pain started to subside. I got the pain back on and off over the next few months but not as badly and now (nervously touches wood) it seems to have completely settled.
I don’t think it was thyroid related but there was clearly an inflammatory process going on there—it wasn’t in my imagination, though both dentist and doctors made me feel like I was malingering.
It sounds like trigeminal neuralgia as it’s been going on so long for you.
Have you tried the whole gamut of painkillers? Ibuprofen did nothing but naproxen worked for me. It’s well worth trying everything you can?
I swear dentists think we make stuff up.
Oh, they do! I had one dentist actually tell me that my toothache was 'all in my head'! He didn't do an xray or anything. It was a tooth he had previously filled, and he didn't believe he could do anything wrong! A while later I saw another dentist who did do an xray, and the tooth was absolutly rotten inside, due to the bad treatment I'd received. All in all, with that dentist, I lost about seven teeth!
Anyway, I told him that if I was going a imagine a pain, it would be something a lot less destressing than toothache!
I had one dentist actually tell me that my toothache was 'all in my head‘.
Well yes. Of course it is. That’s where I keep my teeth—in my head. 😂 For now, anyway...
I think my dentist just couldn’t hack the idea that his beautiful repair work (and it was beautiful, everyone who looked said so 
) could possibly be to blame. But it was. I’m certain of it!
Yes, I did think of saying that, but I don't think he would have understood. He was a bit wierd.
But, yes, same here - the two stories are very similar. He could not accept the fact that he might have botched the job, and didn't even want to look. He changed the subject by criticising the way I cleaned my teeth! Oh, I was furious!
Hi,
I’ve had similar issues for few years.
Constantly going to the dentist and after several xrays and even wisdom tooth removal I was still suffering so I was diagnosed with neuralgia.
I don’t know if it’s connected with hypothyroidism as I’m currently undiagnosed.
Wondering how much levothyroxine are you currently taking
See an old post saying you were left on only starter dose of 50mcg
Guidelines are clear that almost all patients will need to increase dose slowly upwards in 25mcg steps until on full replacement dose
That’s typically 1.6mcg per kilo of your weight
Unless very petite, that will be at least over 100mcg levothyroxine per day
Many people find different brands are not interchangeable
Bloods should be retested if Brand of levothyroxine is changed
guidelines on dose levothyroxine by weight
Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
gp-update.co.uk/Latest-Upda...
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.
BMJ also clear on dose required
bestpractice.bmj.com/topics...
Hi,
Thank you all for your advice. I was on low dose naxopren for a month and while it did help the tmj, it did not ease the teeth pain. I was given Pregablin by a neurologist to try but after 2 weeks, it seemed to intensify the throbbing pain.
I was due to be referred to a pain specialist but then Covid came and it was cancelled
I am still on 50mg Levothyroxine. I went to 2 consultants and they said that was all I needed
Thank you all for your advice, I appreciate it
You poor thing. That’s horrible. Tooth pain/mouth pain is just dreadful because you can’t get away from it, can you? It’s there when you breathe, eat, drink, smile... cry...
And arrrghh, what is it with so-called consultants thinking 50mcg of levothyroxine is fine? It’s never fine!
It could have a lot to do with this, you know. Being chronically undermedicated. What are your Vit D levels like?
My GP does not test vitamin levels.
It's so strange that the only time the pain leaves me is right before bed after I take a sleeping pill
Can you add your actual results and ranges
Obviously essential to test as advised as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Is this how you do your tests?
And essential to test these four vitamins
Please add results and ranges on vitamins too
Yes I get teeth pain! It’s an achey sort of pain all over which feels like you’ve just had your braces tightened!
May or may not be relevant : Check out Sjögren’s syndrome that’s linked with hypothyroid and thyroid issues. The 2 conditions can often appear together. People get issues with their teeth Amongst other symptoms. Alex
Thank you. I will look in to Sjorgens as a possible cause
Have you got hashimotos?? Usually hypothyroidism does not cause pain in face or dental structure except occasionally in Hashimoto’s thyroiditis. In rare cases there is referred pain to the neck ,teeth , ear or upper and lower jaw . This is from “ notes on an endocrinologists lecture” my dentist thought could be abscess but xrays showed nothing he then sent me to dental hospital for deeper xrays in case pain was from something nastier, as he put it. These showed nothing at all which was a relief. For years doctors and four endos said it wasn’t connected to my thyroid , turned out years later I have hashimotos not just under active thyroid .hope this helps
Thank you so much for your reply. I have been told that I do not have Hashimotos, but I do have jaw and neck pain along with the tooth pain. I am on a very long waiting list to see an ENT due to Sinus and Nasal polyps, so I am hoping that he will check my salivary glands in case something there may be the issue.
It could be trigeminal neuralgia - I've seen something recently that suggests there's a link
Thank you. I am starting a trial of Carbezamine in a few weeks which am hoping will help
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